Prospective Payment System (PPS) Coordinator (RN, PT, OT, SLP)

SIGNET HEALTH CORP.; Fresno (CA); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Competitive salary

Comprehensive benefits package

Job summary

Signet Health seeks a Prospective Payment System (PPS) Coordinator for the Community Regional Medical Center rehabilitation program in Fresno, CA. The role focuses on optimizing reimbursement for inpatient rehabilitation services and coordinating IRF-PAI data collection for CMS submissions.

You will educate clinical staff on CMS guidelines, resolve scoring issues, and collaborate with HIM coding to ensure accurate coding and timely reporting of metrics to leadership.

Qualifications

• Experience with CMS data collection and IRF-PAI processes.
• Knowledge of ICD-10 coding and OASIS preferred.
• Ability to educate clinical staff on CMS requirements.

Responsibilities

• Coordinates IRF-PAI data collection for CMS submissions.
• Ensures supporting documentation evidence is complete.
• Educates staff to ensure CMS guideline compliance.
• Resolves GG scoring and rating issues promptly.
• Reviews IRF-PAI data and assists Director with actions.
• Guides rehab physicians on tier code capture for reimbursement.
• Provides audit feedback on scoring, rating and quality.
• Schedules timely completion of IRF-PAI for patients.
• Reports key metrics at daily leadership meetings.
• Collaborates with HIM coding to document applicable codes.

Skills

CMS data collection

IRF-PAI knowledge

ICD-10 coding

CMS guidelines education

Education

California RN licensure or allied health licensure (PT/OT/SLP)

Job description

Acute Inpatient Rehabilitation

Community Regional Medical Center

Signet Health, a national acute rehabilitation and behavioral health company is seeking a Prospective Payment System (PPS) Coordinator for the rehabilitation program at Community Regional Medical Center in Fresno, CA.

The PPS Coordinator plays a vital role in the management and optimization of reimbursement for inpatient rehabilitation services.

Signet Health offers a highly competitive salary and comprehensive benefits package.

Responsibilities include, but are not limited to:

• Coordinates the data collection on the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) for completion and timely submission to CMS.
• Ensures evidence of supporting documentation.
• Provides clinical staff education to ensure compliance with CMS guidelines.
• Coordinates all efforts for immediate issue resolution concerning GG scoring and rating.
• Conducts ongoing review of IRF-PAI related data and assists the Director to address action.
• Provides guidance to rehab physicians and clinical team on capturing tier codes for appropriate reimbursement.
• Provides feedback to the team through audits on scoring, rating, and quality measures.
• Implements a schedule for every patient for timely completion of the IRF-PAI.
• Reports key metrics to the leadership team at daily team meetings.
• Collaborates closely with HIM coding department to identify and document all applicable codes concurrently.

Requirements/Qualifications

Qualifications:

• Current California state licensure in nursing (RN) or allied health profession (PT, OT, SLP) required.
• Minimum of two years experience in rehabilitation or a closely related field required.
• Experience with ICD 10 coding preferred.
• Previous experience with CMS data collection, MDS, IRF-PAI, OASIS.